title: Diagnostic and surgical approaches to recurrent varicose veins of lower limbs.
abstract: A consecutive series of 82 patients (98 legs) suffering from recurrent varicose veins underwent surgical treatment. In all patients clinical and hand-held US Doppler preoperative examinations were performed, but a phlebography was necessary in 33 legs to certainly visualize the anatomy of venous system and the potential sites of recurrent deep to superficial reflux. The causes of recurrence were: incompetent saphenofemoral junction in 59 legs, saphenopopliteal reflux in 6 legs, incompetence of perforator veins in 18 legs, both insufficiencies of great saphena and perforators in 15 legs. Seventy-four legs with saphenofemoral reflux underwent groin redissections through transversal (44 legs) or vertical (30 legs) incisions; the approach to the saphenopopliteal junction was vertical in two legs and transversal in four legs; the interruption of incompetent perforator veins was performed through incisions in 29 legs and according to Linton's technique in 4 legs. Clinical and US Doppler follow-up was performed every 6 months and no recurrent reflux was demonstrated; seven patients were affected from new small varices that were treated by injection sclerotherapy. This study indicates that more than 1/3 of recurrent varices need phlebography to be clearly studied: only diagnostic accuracy may assure a correct surgical approach, but the strategy of treatment must be adapted to the single patient.
authors.affiliation: Geriatric Surgery Division, Second University School of Medicine, Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Canonico
authors.forename: F
authors.initials: F
authors.lastname: Campitiello
authors.forename: V
authors.initials: V
authors.lastname: Lauletta
authors.forename: F
authors.initials: F
authors.lastname: Pacifico
authors.forename: G
authors.initials: G
authors.lastname: Sciaudone
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D014648:Varicose Veins / Q000175:diagnosis* / Q000601:surgery*